When you make a referral to Avow Hospice, (via on-line form, fax, phone request) an Avow Hospice Admission Care Coordinator will come to your facility to speak to the staff, resident and family.
During the admissions visit, the Avow Care Coordinator will explain Avow services and philosophy of care. He/she will answer questions regarding insurance coverage and medication coverage. If/when the patient/family elects Avow services, consent for care forms are prepared by the Care Coordinator for their signature. The Care Coordinator will review medications with the facility staff and the resident/family members and assist the facility staff with coordination of care. The primary care team typically meets with the resident the following day.
After the initial admission visit, Avow will send initial admission orders (PPOC) to the your facility’s referring/attending physician. Once the admission process is complete, we will send a letter to the physician notifying him or her that the patient qualifies and has been admitted to the Avow Hospice program.
We accept patient referrals 24 hours a day, seven (7) days a week.
You may complete our on-line referral form or download, print and fax the referral form below (see "additional resources"). If you prefer to phone in your referral, call (239) 261-4404 and ask for the Admissions department. To help expedite the referral process, please have the following patient information ready:
- Referring Physician or Clinician’s name
- Physician/Clinician phone number
- Resident’s name
- Present location of resident
- Terminal diagnosis
- Urgent needs (If applicable)
- Family contact name (If applicable)
- Family contact phone number (If applicable)
- Is resident aware of the referral?